Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2024 Aug 30;103(35):e39436. doi: 10.1097/MD.0000000000039436.
This study aimed to assess the impact of ultrasound (US)-guided nerve blocks (NBs) on anesthesia and their protective effect on pulmonary function (PF) in patients undergoing distal radius fracture (DRF) surgery. A total of 122 patients undergoing DRF surgery between April 2020 and June 2023 were included. According to the type of peripheral NB technique, these patients were randomized into a control group (CG; n = 60) receiving brachial plexus block (BPB) using blinded techniques, and an observation group (OG; n = 62) receiving US-guided supraclavicular BPB. Anesthetic effects, BPB-related indexes, adverse events, PF parameters (forced expiratory volume in 1 second, forced vital capacity, peak expiratory flow), and serum biochemical indexes (interleukin [IL]-6/10) were compared. The OG showed a relatively higher proportion of good anesthetic effects, shorter onset and completion times of block, and longer block duration compared to the CG, with a lower AE rate. Despite reductions in PF parameters and IL-10 levels after intervention, the OG maintained higher values than the CG. IL-6 levels increased significantly in the OG but remained lower than in the CG. In conclusion, US-guided NBs demonstrated significant anesthetic efficacy and apparently reduced anesthesia adverse events while also exerting a protective effect on PF in DRF surgery patients.
本研究旨在评估超声引导神经阻滞（NBs）对麻醉的影响及其对行桡骨远端骨折（DRF）手术患者肺功能（PF）的保护作用。共纳入 2020 年 4 月至 2023 年 6 月期间行 DRF 手术的 122 例患者。根据外周 NBs 技术类型，将这些患者随机分为接受盲法臂丛神经阻滞（BPB）的对照组（CG；n=60）和接受超声引导锁骨上 BPB 的观察组（OG；n=62）。比较麻醉效果、BPB 相关指标、不良反应、PF 参数（1 秒用力呼气量、用力肺活量、呼气峰流速）和血清生化指标（白细胞介素 [IL]-6/10）。与 CG 相比，OG 显示出相对更高比例的良好麻醉效果、更短的阻滞起效和完成时间以及更长的阻滞持续时间，且不良反应发生率更低。尽管干预后 PF 参数和 IL-10 水平降低，但 OG 仍保持高于 CG 的水平。OG 中 IL-6 水平显著升高，但仍低于 CG。总之，超声引导 NBs 对桡骨远端骨折手术患者具有显著的麻醉效果，明显减少麻醉不良反应，对 PF 具有保护作用。
